“The Boomer” is a column written for adults nearing retirement age and those already in their “golden years.” It will also promote reader interaction by posting e-mail responses and answering reader questions. E-mail your questions or topic ideas to firstname.lastname@example.org.
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While wisdom comes with age, but there are also some less fortunate side effects of growing older: back pain in the morning, “senior” moments, and for some, Type 2 diabetes.
Type 2 diabetes is the most common form of diabetes and occurs when there is a problem in the way the body produces or uses insulin. The symptoms of this chronic disease are more common the older you get, making prevention very important among baby boomers.
The Census Bureau projects that the number of known cases of diabetes increased to 7.4 million Americans in 2000 from 5.4 million in 1980.
Over-weight individuals and people with a family history of the disease are more prone to developing Type 2 diabetes, but there are steps every boomer can take to prevent it.
I spoke with Theresa Garnero, an advanced practice registered nurse, who is board certified in advanced diabetes management and she offered the following lifestyle tips and what boomers need to know about Type 2 diabetes.
Boomer: What steps can boomers take to prevent a Type 2 diabetes diagnosis?
Garnero: The most important strategy to prevent Type 2 diabetes is physical activity followed very closely by healthy eating. Eating sensibly and moving our bodies the way they were meant to move every day for about 30 minutes, should help fend off the disease.
For people who don't exercise, which is the majority of Americans, exercising for 30 minutes seems like a lot, but it is crucial and should be worked into everyone’s schedule.
The Diabetes Prevention Program showed that being active 150 minutes per week or 30 minutes five days a week while eating healthy, worked to prevent diabetes for the majority of participants.
Boomer: What is a major cause of the onset of diabetes?
Garnero: The major cause has to do with a hereditary link followed by having the right environment to activate the gene. If you have a blood relative with diabetes, that puts you at a higher risk. There are certain ethnic groups that have a higher rate of diagnosis: African Americans, Hispanics and Native Americans have a very high rate of diabetes. As we get older, we also become more at risk because our bodies tend to become more insulin resistant.
The obesity epidemic plaguing our country is bringing about kids as young as 6 being diagnosed with Type II diabetes. Women having babies weighing more than 9 lbs are also at risk.
There are also certain medications like steroids that can lead to diabetes.
Boomer: What are the symptoms of Type 2 diabetes?
Garnero: Quite often there are no symptoms of this disease, but some common ones include: feeling tired (especially after a large meal), blurred vision, frequent urination (especially in the middle of the night), dry itchy skin and frequent infections.
Boomer: What lifestyle changes help control the disease?
Garnero: Lifestyle changes and self care are critical to controlling and preventing Type 2 diabetes. Every minute of every day is an opportunity to decide whether you are going to take the path of health or the path that can lead to problems.
The American Association of Diabetes Educators has identified seven self-care behaviors:
1) Eating Right: Healthy meals comprised of the right foods eaten at the right time is important. You don’t want to save all your carbohydrates for one meal—spread them out throughout the day.
2) Staying active: physical activity is not only important for weight management, it can also control glucose levels.
3) Monitoring: people who check their blood sugar do better because they are getting feedback from their bodies about their food choices and stress levels. It’s kind of like monitoring your check book, you want to know how much money is in the bank; with diabetes, you want to know how much sugar is in the bank. It’s also good to monitor your weight, blood pressure and A1C.
4) Taking Medications: Studies show that half of Americans don’t take their prescribed medications. It’s important to have a knowledgeable, up-to-date medical team and that medicine is taken exactly how it is prescribed.
5) Problem Solving: Knowing what resources are available and how to best solve life’s problem situations can make or break you. Even after being diagnosed, and living with diabetes for several years, there will always be new challenges and problems presented because of the disease and how you handle that is important.
6) Reducing Risks: diabetes management is a lot like car maintenance—diabetics need to routinely do health checkups to identify any risks. Things like getting a flu shot and following doctor’s orders will help maintain health. Dental health is connected to diabetes and heart health You could have gum disease and that is the cause of your high blood sugar.
7) Healthy Coping: how you deal with diabetes distress and how you manage everyday life stress is important.
I have personally added an eighth self -care behavior: humor. Laughing lowers glucose as well as C-reactive proteins levels, and it helps to reduce cholesterol.
Boomer: Once diagnosed, is Type 2 diabetes irreversible?
Garnero: No, once you are diagnosed with Type 2 diabetes you can't reverse it. Yes, you can get your blood sugar normal, but if you slam down a soda, your sugar levels are going to go higher than it should. If you are overweight and lose a lot of weight, you can get your blood sugar down so that it doesn't look like there is a problem but given the right environment, the blood sugar will creep higher. There are a lot of scams out there and the Food and Drug Administration has a website that provides legitimate information to investigate any plans or medicines that sound too good to be true.
Boomer: The FDA recently approved Exenatide injection for people with Type 2 diabetes, is this something new and what are the potential side effects of this medicine?
Garnero: Exenatide is one of the newer medicines on the market, and there is a newer one called Victoza and they both work in a similar ways and involve a Gila monster— a venomous lizard found in the southwestern United States. Researchers found that people who were bitten by this lizard would often have low blood sugars or go into pancreatitis. Basically they found a protein within the saliva called exendin-4 and that worked like a hormone called glucogon like peptide 1 or GLP1 This protein or enzyme within the lizard’s saliva mimicked protein that we have in our bodies. The GLP1 causes the pancreas to release more insulin during periods of hyperglycemia--this only gets turned "on" when you have eaten and it helps to control blood sugar. The problem with diabetics is that response is muted so the GLP1 helps the insulin to work like it should. The challenge is that it can cause nausea.
Boomer: Are we close to a cure for either types of diabetes?
Garnero: We are closer with Type 1.
Type 1 has to do with a lack of insulin, which is an easier fix. We use to call Type 1 juvenile diabetes, but there are people in their 40s and 50s with this type. To become Type 1, it means certain antibodies are present and there is a specific test for Type 1. Just because you take insulin does not make you a Type 1. In fact, upwards of 70% of people with Type 2 diabetes will need insulin in their lifetime because the pancreas is fading out.
Type 2 is a whole syndrome of high blood pressure, high cholesterol and high sugar making it much more complex in terms of a cure. Type 1 is an insulin deficiency; Type 2 is insulin deficiency plus resistance.
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